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Full text of "Navy & Marine Corps Medical News 00-20"

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Navy & Marine Corps Medical News (MN-00-20) - May 19, 2000 

The Navy Bureau of medicine and Surgery distributes Navy 
and Marine Corps Medical News (MEDNEWS) to Sailors and 
Marines, their families, civilian employees and retired Navy 
and Marine Corps families . 

MEDNEWS is a weekly compendium of news and information 
contributed by commands throughout the Navy Medical 
department. Information contained in MEDNEWS stories is not 
necessarily endorsed by BUMED, nor should it be considered 
official Navy policy. 

To achieve maximum medical information distribution, your 
command is highly encouraged to distribute MEDNEWS to ALL 
HANDS electronically, include MEDNEWS in command newspapers , 
newsletters and radio and TV news programs. 

Stories in MEDNEWS use these abbreviations after a Navy 
medical professional' s name to show affiliation: MC - Medical 
Corps (physician) ; DC - Dental Corps; NC - Nurse Corps; MSC - 
Medical Service Corps (clinicians, researchers and 
administrative managers) . Hospital Corpsmen (HM) and Dental 
Technician (DT) designators are placed in front of their 
names . 

-USN- 

Contents for this week's MEDNEWS: 

Headline: Submarine deploys 100 percent dental ready 

Headline: Hospital corpsman joins Fleet team 

Headline: Rescuers of lightning strike victim receive medal 

Headline: Independent duty corpsmen: medical jacks of all trades 

Headline: MERCY returns home from San Francisco yards 

Headline: Anthrax question and answer 

Headline: TRICARE question and answer 

Headline: Healthwatch: Dealing with that snake in the grass 

-USN- 

Headline: Submarine deploys 100 percent dental ready 

By JOCS (SW) Darrell Ames and JOCS (SW) Phil Eggman Navy Region 

Hawaii 



PEARL HARBOR, Hawaii — Family and friends said goodbye to 
loved ones stationed on board USS Columbus (SSN 762) , which 
departed May 8 for a six-month deployment to the Western 
Pacific. 

Columbus is a Los Angeles-class submarine equipped with 
sophisticated Advanced Capability and Mark-48 anti- 
submarine/ship torpedoes , Tomahawk and Harpoon cruise 
missiles . 

Submarines can cruise the world's oceans in stealth while 



carrying out a variety of missions and remain one of the most 
lethal weapons in the nation's arsenal. Therefore, it is hard 
to believe that just one toothache could change all that . 

"A dental emergency while deployed could develop into a 
major health threat that could adversely affect our schedule, " 
said Lt.Cmdr. Jeff Truffler, Columbus executive officer. "In 
extreme cases the Sailor would probably have to be medically 
evacuated off the boat . " 

While no one can predict or totally eliminate an 
emergency, 

Columbus ' 127 officers and crew can, nevertheless, feel 
confident their oral health will not jeopardize their mission 
while underway because Naval Dental Center Pearl Harbor 
(NDCPH) has certified her as 100 percent operationally dental 
ready (ODR) . In fact, Columbus is the 50th consecutive 
submarine or surface ship from Pearl Harbor to deploy at 100 
percent ODR, and no one has ever done that before — until 
now. 

"It is crucial that ships and submarines deploy with the 
best possible dental health to decrease the chance of any 
dental emergency underway because most ships and all 
submarines do not have dental facilities on board, " said 
Lt.Cmdr. Patrick Munley, fleet dental liaison officer for 
NDCPH. 

Dental readiness is rated Class 1 through 4 dental health, 
according to Munley. To deploy at 100 percent ODR, each 
member of the crew must be either Class 1 (good dental health) 
or Class 2 (no dental problems foreseeable during deployment) . 
Class 4 means health is unknown, requiring an exam to make 
that determination , and Class 3 means a dental problem needs 
immediate attention, something a submarine or a ship without 
dental facilities can not attend to while deployed. 

"I can do some emergency work if necessary, but I have 
limited resources and facilities on board, " said Hospital 
Corpsman 1st Class (SS/SW) Robert Stewert, Columbus' 
independent duty corpsman. "This is why it means a great deal 
to us for our crew to be 100 percent dental ready. " 

"We have taken dentistry to the deckplates, while 
instilling incentives for our independent duty corpsmen to 
meet ODR requirements , " Munley said, noting an aggressive 
program of combining many services to Sailors. 

"We maximize the use of our mobile dental vans to reach 

our 

fleet and shore customers and embark dental teams aboard ships 
on pre-deployment exercises, " he continued. "We also provide 
'one stop' treatment opportunities for our Sailors (exam plus 
cleaning, or filling plus cleaning) and educate them on the 
value of the services they receive. " 

Stewart is proud of the fact that Columbus is the 50th 

ship 

to deploy at 100 percent ODR and praises the Naval Dental 
Center personnel for their exceptional help. However, he gave 
special praise to Dental Technician 3rd Class Stacy Mitchell, 
NDCPH fleet liaison who helped him get his crew ready for 



deployment . 

"She's been fantastic, " he said. "She keeps us up to date 
on our status, sets up our appointments and more. She's been 
a big part of this." 

Machinist Mate 1st Class (SS) Sam Filson, an Indianapolis , 
Ind. native assigned to Columbus, said he is very satisfied 
with the job the dental clinic and Petty Officer Stewart have 
done getting the crew ready to go. "A dental emergency for me 
underway would be like a life threatening medical emergency, " 
he said. "The suffering would probably be similar. " 

As a customer, Filson praises the use of the pier-side 
dental van, which he says saves everyone a lot of time and 
trouble. 

"It ' s great to be able to walk out on the pier every three or 
four months and get our work done right there, " he said. 

-USN- 

Headline: Hospital corpsman joins Fleet team 

By Lt. Youssef H. Aboul-Enein, MSC, Naval Hospital Great Lakes 

GREAT LAKES, ILL. - Naval Hospital Corps School Great 
Lakes, 111., is where hundreds of hospital corpsmen every year 
begin their careers in the Navy Medical Department and then at 
some point head for the Fleet as sea-going health care 
providers . 

Whether serving as independent duty hospital corpsmen or 
becoming part of a medical department, they ensure the medical 
readiness of Sailors and Marines aboard ships by providing the 
best medical care. 

Hospital Corpsman 2nd Class (SW) Kori Jowhar realized the 
significance of sea-going medical support when he arrived in 
Yokusuka, Japan, to join the crew of the guided missile 
frigate, USS Thach (FFG 43), July 1995. At sea is where the 
hospital corpsman really learns the meaning of teamwork and 
sees further practice of the Navy's core values of Honor, 
Courage and Commitment . 

It was a nervous young hospital corpsman that headed up 

the 

brow of Thach when he first reported aboard. The numerous 
stories about the so-called, "real Navy" ran through his mind, 
and he braced himself for a hard time being the frigate's 
newest sailor. 

Jowhar said that in Corps School the focus was on the 
science, mathematics and tools needed to be a Navy hospital 
corpsman. However, he said he wasn't prepared to be one of 
only two ' docs' aboard a United States Navy frigate at sea. 
He prayed that his training would meet the challenge of this 
new assignment . 

"After I saluted the Ensign on the brow, Senior Chief 
Hospital Corpsman (SW/AW) Jeffrey L. Jones, Thach' s 
independent duty corpsman and my new boss welcomed me aboard, " 
said Jowhar. "As the senior chief showed me around the ship, 
it occurred to me that he and I were the only medical 
personnel on board for the crew of 250 officers and enlisted 
crewmembers . " 



As the weeks went by, the young hospital corpsman learned 

a 

lot from Jones and many others. "A frigate is a tight 
community and no one lives in a vacuum, " said Jowhar. 

He said that replenishing medical supplies , arranging 
patient meals and coordinating a medical evacuation were 
examples of the cooperation and coordination needed with other 
departments on the ship. 

"Medical providers cannot confine themselves to the 
medical 

spaces only and expect to successfully support the ship, " said 
Jowhar. 

As the only two medical representatives on board some 
people believe that all medical personnel do is hold sick call 
in the morning and call it a day. But there was more than 
sick call to the workday of Jowhar and Jones. 

To ensure proper medical care they had to maintain medical 
and dental records. Healthy food preparation and eating 
spaces were assured by inspecting galley spaces and food 
products, as well as testing potable water supplies . 

It seemed a hospital corpsman could be inserted into 
almost 

any of the ship's activities wherever there was the potential 
for injury. Thatch personnel conducted search and seizures on 
the high seas and the ship's two medical providers had to 
standby for casualties if a boarding operation went wrong. 

Then there were the many evolutions that demanded medical 
support such as flight quarters, underway replenishment, 
general quarters and man overboard drills. 

Fleet corpsmen are an integral part of operations 
worldwide 

and many are given singular responsibilities straight out of 
Hospital Corps School. Jowhar advises newly reporting ship's 
corpsmen to take pride in what they do for the ship. He said 
that no duty however small is insignificant, and everyone has 
a part to play. 

-USN- 

Headline: Rescuers of lightning strike victim receive medals 
By Rod Duren, Naval Hospital Pensacola 

PENSACOLA, Fla. - Two Navy medical officers and a Blue 
Angels pilot received the Navy and Marine Corps Medal in a 
ceremony here May 9 for their rescue of a wind surfer struck 
by lightning. 

Lt . Cmdr. Pat McMahon, MC, the Blue Angels' flight 
surgeon; 

Lt . Cmdr. Paul Mollere, MC, a Navy reserve radiology resident 
at Tulane University in New Orleans, La., and Blue Angels 
pilot Maj. Bruce Shank, USMC, were awarded the medal for 
rescuing Air Force 2nd Lt . Nolan Porter. 

The three officers were on the water in a pleasure craft 
when Porter was struck by lightning after a sudden storm 
developed. McMahon was among the first of the Navy medical 
personnel to reach him. 



"J was pretty scared, " said McMahon of Bremerton, Wash., 
"because there was still a great deal of lightning all around 
us." 

The three had been heading for shelter because of the 
sudden arrival of the storm when they heard anxious voices 
calling for help. Maj. Shank, the No. 8 pilot for the Blue 
Angels, guided his boat to where the commotion was taking 
place, while rain and vicious lightning continued to pop all 
around them. 

McMahon and Mollere dove into the rough waters to retrieve 
the windsurfer, lifting him into the ski boat. McMahon began 
cardiopulmonary resuscitation efforts while Shank navigated 
the boat back to the safety of the marina. 

Porter, who had been given little chance for survival 

after 

being struck in the August 1999 incident, did recover fully 
and arrived here from his home in Salt Lake city, Utah, to 
meet with his three principal rescuers . 

Porter still becomes emotional when talking about the 
incident . He said he was very excited about seeing the three 
naval officers. 

"They are certainly deserving of the Navy and Marine Corps 
Medal, " he said. 

-USN- 

Headline: Independent duty corpsmen: medical jacks of all 
trades 

By Judith Robertson, Naval Hospital Bremerton 

BREMERTON, Wash. — If you say they are the Jacks of all 
trades, you are close to the truth and they are proud of it. 
They work on small ships, subs, remote field operations and 
Medical Civil Action Programs. They are the front-line 
medical care for anything — as trivial as a splinter, as 
serious as a heart attack. 

They are independent duty corpsmen, or more familiarly, 
IDC, and as their name implies, they work alone. They are 
mature, professional, caring and dedicated individuals 
respected by their patients who just call them 'doc. ' 

Thirty-eight IDC participated in the 7th Annual Pacific 
Northwest IDC conference Apr. 26-28 at Submarine Base Bangor, 
Wash. Sponsored by Naval Hospital Bremerton, the conference 
was designed to provide 16 continuing medical education 
credits necessary for IDC to remain current with medical 
updates, labs on airway management and the current medical 
treatment guidelines for Fleet IDC. 

Aside from the "Professional Development of the IDC" 
segment, the agenda for the three-day conference read like a 
medical journal, covering such disparate subjects as "Anti- 
histamines and Allergies , " "Pitfalls in Treating Abdominal 
Pain in Females, " "Eye Trauma, " and "Urological Emergencies . " 
It was these billings that drew IDC from as far away as 
Washington, D.C., Millington, Tenn., and San Diego, Calif. 

IDC detailers attended the conference, and according to 
Senior Chief Hospital Corpsman (SS/FMF) Craig Kelley, IDC 



program manager at the hospital, the detailers were not only 
able to get a good feel for the issues of the IDC they serve, 
but could also take advantage of the educational offerings. 

"IDC detailers still need to keep their CME current . So 

it 

was a working visit, " Kelley said. "We are providing 
professional education in primary and emergency care; it is 
the most important thing for an IDC. " 

For Chief Hospital Corpsman (FMF) Frank Percy, who works 

at 

the Fire Fighting Division, Fleet Training School, San Diego, 
Calif. , this venue for getting CME credits is "the best, " 
because it provided the opportunity to talk to specialists in 
the field. 

"Normally, all my questions go to a general practitioner, 
which is usually no problem, but if you have a detailed 
question about the eye that's been bothering you, here's where 
you can get it answered by an eye specialist. Psychiatry is 
another specialty area where contact with a specialist is a 
benefit. " 

With an ever-increasing number of females in the Navy, 
Percy found the session on female abdominal pain the most 
valuable. While this particular subject might not be quite so 
foreign to Hospital Corpsman 1st Class (SW) Kathleen Michalski, 
the doc aboard USS Paul F. Foster (DD 964), the conference 
proved invaluable. 

"The lectures are very appropriate for what we deal with 
day to day. It helps to answer questions that are always 
looming in the back of our heads. And the manual is 
excellent, very well organized. " 

IDC must first serve at least two years as a Hospital 
Corpsmen 2nd Class before they are eligible to attend the 
Navy's year-long Independent Corpsmen School. After 
graduation they are prepared to medically support all aspects 
of Navy and Marine Corps operations. 

"Personally I feel they are indispensable, Kelley said. 

Kelley had a real taste of just how indispensable when he 
went to a remote region in northern Vietnam last year in 
support of a State Dept . sponsored Medical Civil Action 
Program. "I was the sole care provider there. I saw more 
than 300 patients in four weeks: sick babies, aged women, 
malnutrition, broken bones, malaria, you name it. It was an 
area under served by medicine for years. " 

For Hospital Corpsman 2nd Class Jerry Smith (DV/NAC) , a 
diver medicine technician with the Submarine Development Group 
based at Bangor, the training helped in his aspirations to 
become an IDC. 

This is really good information. The more training, the 
better, " Smith said. 

Aside from training, participants at the conference gained 
something more. "It provided a great opportunity to liaison 
with others in the field. Some have been in for awhile and 
have really good insight and experience, " said Michalski, who 
is in her first year as an IDC. 



Michalski and other conference attendees learned, among 
other valuable lessons, that while they work independently, 
they are not alone. 

-USN- 

Headline: MERCY returns home from San Francisco yards 
By J02 Stacie Rose, Navy Compass Staff Writer 

SAN DIEGO, Calif. — Hospital ship USNS Mercy (T-AH 19) 
returned to Naval Station San Diego recently after two months 
in the San Francisco shipyards. 

Upon first glance, Mercy seems like her old self. Take a 
closer look, however, and you'll see the difference a $4 
million rework and 30 Sailors can make. 

Only a portion of the reduced operating status crew stayed 
behind in San Francisco, taking care of duties normally 
reserved for the entire crew, including roving watches every 
two hours, sweepers three times day and a general field day 
two times a week. 

Contractors undertook large tasks such as hull repair, 
ballast tank preservation and heating and ventilation work. 

However, Mercy's crew did their share of work as well. 

They replaced equipment on over 300 bunks, laid four 
thousand square feet of tiling on the mess decks, hospital 
administration and supply spaces and painted the mid-ship ramp 
that leads from the main deck to the 0-1 level . 

"With such a reduced crew, our biggest challenges were 
cleanliness and security, " said Capt . Justus Benjamin, MSC, 
executive officer of the medical treatment facility aboard 
Mercy. "But the crew pulled together and got everything done." 

-USN- 

Headline: Anthrax question and answer 
From Bureau of Medicine and Surgery 

Question: What is the cost of the vaccination program? 

Answer: The current cost of a single dose of anthrax 
vaccine is approximately $10.64. The full six-dose regimen 
costs about $63.84. This per-dose price is lower than the 
cost of some vaccines on CDC contracts and considerably lower 
than most civilian vaccine prices (see 

http://www.cdc.gov/nip/vfc/vaccines.htm). When all associated 
costs (transportation, storage, administration, etc.) are 
included, the cost to vaccinate an estimated 2.4 million 
personnel (over a seven to eight-year period) will exceed $200 
million. 

For more information visit the Navy medical anthrax 
website 

at http://www-nehc.med.navy.mil/prevmed/epi/anthrax or the DOD 
anthrax website at http://www.anthrax.osd.mil. 

-USN- 

Headline: TRICARE question and answer 
From Bureau of Medicine and Surgery 

Question: How can I get a listing of Primary Care Managers and 
other network providers? 

Answer: A listing of network providers (Provider 
Directory) 



in your area is available at your local TRICARE Service 
Center. 

For more information, visit the TRICARE website at 
http: //www. tricare . osd.mil . 

-USN- 

Headline: Healthwatch : Dealing with that snake in the grass 
From American Forces Press Service 

WASHINGTON, May 16, 2000 — We call people we don't like a 
"snake. " We call people who stab us in the back a "snake in 
the grass. " 

Westerners see snakes as evil, and that seems to color 
thinking about the reptiles. U.S. service members are based 
around the world and spend a lot of time in the bush. It's 
almost inevitable they will confront poisonous snakes. For 
most of us, there's the temptation to act like a certain 
"B.C." comic strip character and start whomping them. 

But snakes, especially poisonous snakes in the United 
States, are generally shy and are generally as scared of you 
as you are of them. Most of the time, snakes will move to 
avoid you. 

In 1989, the most recent year for snakebite statistics 
worldwide, there were 300,000 reported snakebites. They 
resulted in 30, 000 deaths — 20, 000 in India, said Bela 
Demeter, a biologist with the department of herpetology at the 
Smithsonian Institution's National Zoological Park in 
Washington . 

In the United States, 7, 000 venomous snakebites are 
reported annually resulting in 15 fatalities. So, even if you 
are bitten, your odds of surviving are roughly 466 out of 467 
or far more than 99 percent . 

In this area, prevention is the best cure. Males ages 15 
to 30 suffer the most venomous snakebites, and many of them 
occur on the arms from the hand to elbow. 

"What's that say to you?" asked Bill Kane, director of 
education at SOLO, the wilderness education center in Conway, 
N.H. "It means these guys are picking up poisonous snakes. " 
Kane said most of these poisonous snakebites happen in the 
Southeast and Southwest . 

"Just leave them alone, " he said. The Centers for Disease 
Control statistics agree with Kane. The CDC classifies about 
3, 000 of the snakebites per year as "illegitimate, " meaning 
"these bites occurred while the victim was handling or 
molesting the snake. " CDC statistics show that 85 percent of 
"legitimate" snakebites in the United States occur below the 
knee. 

Even if a poisonous snake bites you, 30-50 percent of 

bites 

from them do not result in being injected with venom. Not 
exactly great odds for the person being bitten. Rattlesnakes, 
cottonmouths and copperheads are pit vipers and are the most 
common poisonous snakes in America. Although some say that 
snakes only inject venom when attacking a food source, other 
snake experts say that isn't so. The lesson for people is to 
not take a chance. The strike may or may not result in a dry 



bite. 

Pit vipers inject poison through two fangs. Generally, a 
bite would create two puncture wounds. If the snake injected 
venom, the victim will feel intense, burning pain and swelling 
around the holes. 

The species and size of the snake has a lot to do with how 
dangerous its poison is. "The Mojave rattlesnake has a really 
bad venom, " Demeter said. "And for pure size, the six-foot 
Eastern diamondback (rattlesnake) has a massive bite. But you 
really never know how much is injected, it runs the spectrum 
from no venom to a lot. " 

The one piece of first aid people should remember is to 

not 

panic. "Contrary to myth, " Demeter said, "there ' s no such 
thing as a ' one- stepper ' or a 'two- stepper ' " — that's the 
power of the snake venom expressed as the number of steps you 
can take before you keel over dead. "The toxicity of these 
snakes is highly exaggerated. " 

What people need to do is to receive treatment as soon as 
possible after being bitten, he said. 

DoD officials said military medics carry antivenom. A 
Soldier, Sailor, Airman or Marine bitten by a poisonous snake 
is usually only minutes away from treatment. Antivenom, once 
solely developed from equine serum, now comes from sheep, 
goats and rabbits. 

"It's best not to do a whole lot, " Demeter said. "If you 
have not done first aid on a snake bite, then you haven't done 
anything wrong yet . " 

The most commonly recommended treatment today is to keep 
the bite area immobilized below the level of the heart. Kane 
said medics can place a light constricting band between the 
bite and the heart . "The problem is that many people get 
carried away, " Kane said. "That band turns into a tourniquet. 
You don't want to do that." 

Remove any jewelry the person may be wearing . Swelling 
from the snakebite can progress rapidly, so rings, watches and 
bracelets can turn into a real problem. 

Kane said medics can use a syringe-like Sawyer Extractor 

to 

suck venom from the bite site, but that 's only effective if 
used within seconds of a bite. " 

Get the victim to a hospital as quickly as possible . 
Antivenom serum is the only sure cure, and because some people 
are allergic to horse serum it should only be given in a fully 
equipped medical facility . 

In the United States, don't be concerned about capturing 
the snake for identification. Remember, it bit once and will 
bite again. All viper species in the United States are 
covered by the Wyeth Polyvalent antivenom product . 

Don't use ice to slow the spread of the venom. 
Researchers 

have found freezing of the stricken limb is a major factor 
leading to amputation . 

Another caution is to know that the biting reflex in 



snakes 

remains up to two hours post-mortem. Victims have been bitten 
and killed by carelessly handling a severed head of a venomous 
snake . 

The best cure for snakebite is prevention. Here's the 

CDC's 
tips : 

- Do not play with snakes. 

- Keep landscape well manicured. 

- Wear shoes when outdoors . 

- Wear gloves when weeding. 

- Wear boots in snake country . 

- Develop the habit of watching where you step and where you 
place your hands. 

-USN- 

Comments about and ideas for MEDNEWS are welcome . Story 
submissions are encouraged. Contact MEDNEWS editor, Earl W. 
Hicks, at email: mednews@us.med.navy.mil; Telephone 202/762- 
3223, (DSN) 762-3223, or fax 202/762-3224. 

-USN- 

-USN-